Neena Petersen

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

26443 Issued in MD

Practice address

403 Ben Oaks Dr W
Severna Park, MD 21146-2208

Phone

(760) 846-2295

NPI assigned

Aug 5, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Neena Capolupo Former name

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peak Balance Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Severna Park, MD
  • NPI 1770294951

  Physical Therapist

  NPD Authorized official
• Water and Sports Physical Therapy

  • Physical Medicine & Rehabilitation Physician
  • San Diego, CA
  • NPI 1588085625
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670630400000",
    "number": "1144639097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 BEN OAKS DR W",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462208",
            "telephone_number": "760-846-2295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 BEN OAKS DR W",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462208",
            "telephone_number": "760-846-2295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "NEENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2022-12-10",
        "certification_date": "2022-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NEENA",
            "last_name": "CAPOLUPO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Perform for Life Physical Therapy
• Performance Physical Therapy Inc
• James Perritt, NP
• Timothy Perry
• Marie Ryan Pessagno
• William David Petok, PH.D.
• Elaine Marie Petrucci, LPN
• Michelle Lauren Phillips
• Emily Phipps
• Mercedes Phipps

• Physical Therapist in Severna Park, MD
• Providers in Severna Park, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.